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目的:探讨对腋淋巴结阳性乳腺癌患者行Kodama术式的应用临床及意义。方法:322例乳腺癌患者,154例临床腋淋巴结阳性乳腺癌患者采用Kodama术式,168例行常规Auchinclos改良根治术式,对两组情况进行比较,同时随访观察患者的预后情况。结果:两组患者手术时间差异无统计学意义,行改进术式患者腋下清扫淋巴结总数及L3组淋巴结数较常规术式多,两组差异有统计学意义,Kodama术式组患者5年无瘤生存率为58.9%,常规术式组患者5年无瘤生存率为51.1%,两组差异无统计学意义。结论:对临床腋淋巴结阳性乳腺癌患者行全腋下淋巴结清扫具有一定的临床应用价值,采用Kodama术式有利于对L3组淋巴结的清扫。
Objective: To investigate the clinical application of Kodama technique in patients with axillary lymph node positive breast cancer. Methods: 322 cases of breast cancer patients and 154 cases of clinical axillary lymph node positive breast cancer patients using Kodama operation, 168 routine modified Auchinclos radical mastectomy, the two groups were compared, at the same time follow-up observation of patients with prognosis. Results: There was no significant difference in operative time between the two groups. The total number of axillary lymph nodes and the number of lymph nodes in L3 group were significantly higher than those of conventional surgical methods. The difference between the two groups was statistically significant. There was no significant difference between the two groups in 5 years The tumor survival rate was 58.9%. The 5-year disease-free survival rate was 51.1% in the conventional operation group. There was no significant difference between the two groups. Conclusion: It is of clinical significance to perform full axillary lymph node dissection in patients with axillary lymph node positive breast cancer. Kodama technique is helpful for the dissection of lymph nodes in L3 group.